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HomeMy WebLinkAboutAFLAC INCORPORATED - INSURANCE CERTIFICATE (6)Client#: 103008 30AFLACINCOR ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 5/15/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Connie Whitmer J Smith Lanier & Co. Columbus PHONE FAX ' Ext 706 324-6671 ac No : 706 576-5607 Marsh &McLennan Agency, LLC E-JC,MAIL ADDRESS: cwhitmer@jsmithlanier.com 200 Brookstone Centre Pkwy;118 Columbus, GA 31904 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Great Northern Ins A++ XV 20303 INSURED INSURER B : Federal Insurance A++ XV 20281 Aflac Incorporated INSURER C : Pacific Indemnity Co A++ XV 20346 Attn: Mary Rogers 1932 Wynnton Road INSURER D : Columbus, GA 31999 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUB WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR 35960492 5/16/2017 05/16/2018 EACH OCCURRENCE $1 000 000 PREMISESOERENTED nce $1 000 000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPPLLIIIEES PER: POLICY � ECT ^ LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 Gen A99 Ca $40,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS 73580109 5/16/2017 05/16/201 COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 79825301 5/16/2017 05/16/2018 EACH OCCURRENCE s25,000,000 AGGREGATE $25 000 000 DED I X RETENTION $$0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 71716058 5/16/2017 05/16/201 X PER OTH- TAT T E.L. EACH ACCIDENT $500OOO E.L. DISEASE - EA EMPLOYEE $500 000 E.L. DISEASE - POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of Fort Collins 215 North Mason, 2nd Floor Fort Collins, CO 80524-0000 LhilCCtlal�GllC�L` SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1998-7014 ACORD CORPORATION. All rights reserved ACORD 25 (2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD #S3440592/M3440483 CWW